Purpose: This paper aims to explore the conditions needed for sustainable community based rehabilitation (CBR) programmes for persons with disabilities in Vietnam, and to identify the conditions and opportunities missing at present for the implementation of such programmes.Method: Two CBR programmes in Vietnam, one medical based and one comprehensive (medical, educational, livelihood, social and empowerment), were evaluated for requirements and the current situation. Four factors were taken into account - human resources, organisational setting, social and political environment, and financing. Data were collected through interviews with programme managers and focus groups with stakeholders from provincial, district and communal levels, and with persons with disabilities. Persons with disabilities also completed a questionnaire to evaluate their satisfaction with the programme and their involvement in it.Results: The conditions needed for a sustainable CBR programme were identified: availability of human resources, training, monitoring and evaluation, collaboration, commitment and financing. The conditions missing at present were: a stable pool of human resources (in both programmes), collaboration between sectors and with local authorities (in the medical programme), and knowledge about how to maintain financing (in both programmes). Persons with disabilities were more satisfied with their involvement in the comprehensive programme than in the medical programme. Stakeholders proposed opportunities to increase sustainability; highest priority was given to a collaboration plan (comprehensive CBR programme) and to involvement of other sectors in the CBR Steering Committee (medical CBR programme).Conclusions: Few differences were found in conditions needed for sustainability of the medical and comprehensive programmes. The existence of disabled persons’ organisations (DPOs) seemed to be associated with the level of satisfaction persons with disabilities felt with their involvement in the programme.Limitations: The People’s Committee was not involved in this research, although their input was perceived to be important. Generalisation of the results of this study should be done with caution because health system structures and organisational levels of CBR differ.Key words: CBR, Rehabilitation programmes, sustainability, strategies doi 10.5463/DCID.v22i2.54

Participatory and interdisciplinary approaches have been suggested to develop appropriate agricultural innovations as an alternative strategy to improve food security and well-being among HIV/AIDS affected households. However, sustainable implementation of such interactive approaches is far from easy and straight forward. This study reports of the Interactive Learning and Action (ILA) approach, a methodology for agricultural innovation which has been adapted to the context of HIV/AIDS. Role players in agriculture and health were brought together to stimulate and sustain innovation among three support groups for poor and affected households in a rural high HIV/AIDS prevalence area in South Africa. The effectiveness of the approach was evaluated using both outcome and process criteria. The results indicate that an interactive approach in which service providers/researchers engage themselves as actors to explore the livelihood system and develop appropriate solutions in joint collaboration with resource users has potential. However, it also revealed that cooperation among participants and stakeholders at the interface of agriculture and HIV/AIDS is complicated and sensitive to erosion. Of particular concern was the difficulty of mobilizing members from poor and affected households to participate and to overcome stigma and discrimination. Lessons and potential applications for the further development of interactive approaches are discussed.

To gain a more comprehensive understanding of the impact of HIV and AIDS on rural households in Msinga, South Africa, the sustainable livelihoods framework was adapted. An ethnographic perspective was employed to examine: 1) the impact of HIV/AIDS-related illnesses on people's mind and spirit (the internal environment), and 2) the influence of institutional structures and processes (the external environment), in order to better understand 3) the actions taken by individuals and households in response to HIV and AIDS. Members of three support groups at a local drop-in centre were consulted about the impact of HIV and AIDS on their lives through focus groups, a questionnaire and in-depth interviews. The study shows that the psychosocial impact and associated coping strategies, as well as prevailing gender-based power relations and exclusion from social-exchange networks - which are not (readily) available factors in the sustainable livelihoods framework - affect people's lives in different ways and depend on the specific situation of the individual or household concerned. The study confirms the need to restore a household's resource base and to address psychosocial issues. However, the variation in impact to different households requires a diversified and holistic programme of development interventions.

One of the main problems in Southern Africa in relation to HIV/AIDS is food insecurity. The vicious relation between malnutrition, HIV infection and AIDS impact drives individuals, households and communities in a downwards spiral of impoverishment. Although scientists and development practitioners have stressed the importance of interactive approaches to mitigate the impact of AIDS on agriculture and rural development, sustainable implementation is far from easy and straightforward. This study aims to gain insight into the main lessons and challenges with respect to their design and implementation. Literature review of interactive approaches in agriculture and natural resource management shows that several principles and process guidelines are considered key factors to successful implementation. Although HIV/AIDS does not seem to change these conditions, personal experiences from researchers, development practitioners and extension workers do reveal new and unforeseen challenges.

The host-foraging behavior of female entomophagous parasitoids is commonly modified by positive associative learning. Typically, a rewarding experience (e.g., successful oviposition in a host) increases a female's foraging effort in a host microhabitat of the type associated with that experience. Less well understood are the effects of unrewarding experiences (i.e., unsuccessful foraging). The influence of unrewarding experience on microhabitat choice and residence time within a microhabitat was examined for the eucoilid parasitoid,Leptopilina heterotoma, in laboratory and greenhouse assays. As determined previously, females which oviposited successfully in either of two microhabitat types (fermenting apple or decaying mushroom) strongly preferred to forage subsequently on that microhabitat type. However, failure to find hosts in the formerly rewarding microhabitat caused females to reverse their preference in favor of a novel microhabitat type. The effect, though striking, was transient: within 1–2 h, the original learned preference was nearly fully restored. Similar effects of unrewarding experiences were observed with respect to the length of time spent foraging in a microhabitat. As determined previously, oviposition experience in a particular microhabitat type increased the time spent foraging in a patch of that microhabitat type. However, failure to find hosts in the patch caused the time a wasp spent in the next unoccupied patch of that type to decrease to almost nothing. In addition, there was a tendency for an unrewarding experience on a formerly rewarding microhabitat type to extend the time spent in a patch of a novel type. The function of the observed effects of unrewarding experiences is discussed.